Men’s Health magazine’s “The Most Active (and Least) Active Cities” rankings named the Kentucky locale the most sedentary city in America. Eighteen others also received failing grades, the vast majority of which are in the South. (Hold the butter and cheese grits.)

Seattle and San Francisco are the most physically active cities, according to the magazine. The other fittest include (in descending order): Oakland, District of Columbia, Salt Lake City, Reno, Portland, Atlanta, Denver and Minneapolis.

Men’s Health weighed several factors: how often people exercise, the percentage of households that watch 15+ hours of cable a week and buy more than 11 video games annually, and the rate of deaths from deep-vein thrombosis, a blood clot in the leg that can be caused by too much sitting around. Its criteria also counted any physical activity in the past month.